Severe insomnia past week. The only thing that worked well was 2 mg clonazepam

I've been on clonazepam almost daily since late 2014 (6 years). I'm 39 years old. I have used a 0.5 mg dose everyday, but sometimes a 1 mg or 1.5 mg when I have an anxiety attack. I've been tapering off the past couple of weeks going down 0.125 mg per week.

 

I was sleeping fine up until last Friday (Nov 20), however, I've had really bad insomnia the past week since I tried to change my sleep schedule from going to bed at 9 AM, waking up at 5 PM, to going to bed at 10 PM, waking up at 6 AM, all in a single day last Friday (I guess that was like flying 13 time zones in a day). The first night I didn't sleep at all, the 2nd night I got about 2 hours of sleep. I guess I should have just gone to bed an hour later everyday, oh well.

 

The past week:

Melatonin 1-3 mg didn't work at all.

 

50 mg of Trazodone + 1 mg clonazepam didn't work at all, 100 mg (or 150 mg) Trazodone + 1 mg clonazepam put me to sleep a few hours, but then I woke up with heart racing and I'm wide awake again.

 

10 mg of Ambien didn't work...I felt like I was half awake/half asleep all night (definitely aware that I was awake), but I didn't feel tired the next day. It was weird.

 

Two nights ago I still couldn't fall asleep at all, but I tried 50 mg Trazodone/5 mg Ambien after several hours to try to sleep. Didn't help (or maybe I got 30 minutes of sleep).

 

2 mg clonazepam worked pretty well last night, I woke up a bunch of times but felt more rested today than I have in a week.

 

1 mg of clonazepam doesn't make me sleepy at all now. That worries me. In 2013 the first time I was prescribed clonazepam (also for extreme insomnia & anxiety attacks at the time), 1 mg put me in a deep sleep for 8 hours.

 

2 questions:

1. Any recommendations for this insomnia right now? Stick with 2mg clonazepam for a week until my body adjusts to sleeping normally, then stop? Just do Trazodone? Something else? I called my pdoc Friday, she said "Well, Trazodone can go up to 300 mg. Or we could try amitriptyline."

2. If I weaned completely off clonazepam, how long would it take for my brain to adjust back to how it used to be when 1 mg of clonazepam would put me to sleep all night?

It's tough to change sleep schedules like that, but increasing your klonopin to compensate might not be a good long-term strategy.  If your intention is to get off of these drugs, I think you're going to need to redefine (i.e. break) the connection your brain has made between klonopin and sleep (or using klonopin to deal with anxiety).  Some degree of insomnia is probably inevitable as you taper/withdraw/heal.  Try to be good with being awake at 3 am.  Getting upset about it only makes it worse.

 

Melatonin did nothing for me either.  Unisom (doxy) worked a little, but I limited its use to 2-3 times a week.

 

If you weaned off completely, I imagine it would take several months for klonopin to work like it used to.  However, once you began taking the drug again your body would adapt to the klonopin faster than it did originally, so you'd end up up-dosing fairly soon.  That's one of the joys of this class of drugs.

Try to be good with being awake at 3 am.  Getting upset about it only makes it worse.

 

Thanks. So waking up at 3 AM every night is OK (for now)? I was thinking I needed to train my brain to sleep straight through the night again, and the 2mg Klonopin basically did that last night. Maybe after a week my sleep would be back to normal and I could resume tapering off Klonopin again.

 

There's also the body clock thing...I jumped ahead 13 hours, so it takes 1 day per 1 hour to get your body clock back to normal, which would be like 2 weeks. It's been 1 week. The reason I changed my sleep schedule was I read that shift workers who sleep all day and work at night have like a 40% higher risk of various cancers....probably has something to do with the brain producing melatonin at night (melatonin has an anti-cancer effect), but being awake all night with the lights on suppresses melatonin production. Also I decided I really prefer being awake in the daytime. Going to bed in the morning when it's bright light outside kinda sucks.

I chased sleep for years with alcohol, Klonopin and Ambien but I never caught it until I gave all of them up.  Taking hypnotics and benzo's don't provide quality sleep, you're not reaching REM and taking them isn't sustainable because you're always going to develop tolerance which will lead to ever increasing doses which will prove ineffective.

 

I hope you can find your way off of these drugs because for me, it was the only way. 

I took klonopin (then Ativan) for years and it did not train my brain to sleep.  As soon as I stopped using it, my sleep fell apart (actually, it was beginning to fall apart before I stopped using it).  Benzos don't train your brain into a good sleeping regime.  Actually, the quality of sleep structure is compromised when using benzos. 

I took klonopin (then Ativan) for years and it did not train my brain to sleep.  As soon as I stopped using it, my sleep fell apart (actually, it was beginning to fall apart before I stopped using it).  Benzos don't train your brain into a good sleeping regime.  Actually, the quality of sleep structure is compromised when using benzos.

 

Do you think I should not take anything? I probably won't sleep for days and that really sucks. I've had a period of extreme insomnia before that lasted a month in Feb-March 2013...first I had an extreme anxiety attack which caused me to go 3 nights in a row with zero sleep, then I got about 2 hours of sleep a night for the next month. I tried everything OTC - Benadryl, Nyquil, melatonin, herbs, nothing worked. It was really torture, but I was afraid to get on psychoactive drugs. Finally I went to the doctor and taking 1 mg Klonopin a night for a week got me back to normal, then I stopped the Klonopin. Everything was fine. (Well, I took it a few more times in the next 18 months when I had an anxiety attack...then daily 0.5 mg starting in late 2014.)

Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABAA receptor, resulting in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties. When you stop taking benzos or take less of them then this reaction does not happen or happens very little. The brain becomes dependent on the Benzos for GABA and stops producing GABA on it own like it does in a person not taking benzos. GABA is essential for normal R.E.M SLEEP so this is why you have insomnia. Cut the benzos to fast and you will have zero sleep. Taper the benzos properly and you will regain deep R.E.M. sleep. You will sleep like a baby again. This is why benzos are so evil.

I wouldn't say that you shouldn't try anything, but maybe try to steer clear of updosing benzos for sleep.

 

I tried a few things (melatonin, benadryl, trazodone, unisom, 'herb', valerian root).  Nothing worked very well for a while.  I slept very poorly for several weeks.  I often felt like I hadn't slept at all, but probably did have an hour or two of broken sleep most nights.  Unisom worked the best, but that was still only 2-4 hours a night.  A little herb before bedtime also helped with sleep onset, but I'd wake up 1-2 hours later.

 

The insomnia sucks, but it doesn't last forever.

Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABAA receptor, resulting in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties. When you stop taking benzos or take less of them then this reaction does not happen or happens very little. The brain becomes dependent on the Benzos for GABA and stops producing GABA on it own like it does in a person not taking benzos. GABA is essential for normal R.E.M SLEEP so this is why you have insomnia. Cut the benzos to fast and you will have zero sleep. Taper the benzos properly and you will regain deep R.E.M. sleep. You will sleep like a baby again. This is why benzos are so evil.

 

I've been taking 0.5 mg Klonopin daily for several years, and I've been tapering down 0.125 mg (1/4 pill) per week this month. Is that too fast? How slow should I taper 0.5 mg?

 

Also is Gabapentin OK for insomnia? I've tried that before (300 mg) and it was pretty good for sleep. Or is Gabapentin not good because it works on GABA like benzos do?

 

I think this particular insomnia is due to me shifting my sleep schedule forward ~12 hours all of a sudden,  because I was sleeping fine before that when I was tapering this month.

Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABAA receptor, resulting in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties. When you stop taking benzos or take less of them then this reaction does not happen or happens very little. The brain becomes dependent on the Benzos for GABA and stops producing GABA on it own like it does in a person not taking benzos. GABA is essential for normal R.E.M SLEEP so this is why you have insomnia. Cut the benzos to fast and you will have zero sleep. Taper the benzos properly and you will regain deep R.E.M. sleep. You will sleep like a baby again. This is why benzos are so evil.

 

I've been taking 0.5 mg Klonopin daily for several years, and I've been tapering down 0.125 mg (1/4 pill) per week this month. Is that too fast? How slow should I taper 0.5 mg?

 

Also is Gabapentin OK for insomnia? I've tried that before (300 mg) and it was pretty good for sleep. Or is Gabapentin not good because it works on GABA like benzos do?

 

I think this particular insomnia is due to me shifting my sleep schedule forward ~12 hours all of a sudden,  because I was sleeping fine before that when I was tapering this month.

 

I am on gabapentin for autoimmune nerve pain and restless leg syndrome. In spite of using gabapentin for various things during my taper, I have successfully tapered off of my benzo. My doctor allowed me to occasionally up my gabapentin bedtime dose for sleep if I had a very bad pain flare. I did this during my benzo taper. I took the extra gabapentin for 2 or 3 days no more than once/month and then dropped right back down again to my regular neuropathy dose. If you use gabapentin regularly for sleep, you will likely become dependent on it. It will also probably stop working for sleep as you habituate to it. Then you will have another useless drug to taper off of. I have managed with difficulty to cut my gabapentin dose in half. It can be a beast to taper for some people, so I would advise against using it regularly.

 

Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABAA receptor, resulting in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties. When you stop taking benzos or take less of them then this reaction does not happen or happens very little. The brain becomes dependent on the Benzos for GABA and stops producing GABA on it own like it does in a person not taking benzos. GABA is essential for normal R.E.M SLEEP so this is why you have insomnia. Cut the benzos to fast and you will have zero sleep. Taper the benzos properly and you will regain deep R.E.M. sleep. You will sleep like a baby again. This is why benzos are so evil.

 

I've been taking 0.5 mg Klonopin daily for several years, and I've been tapering down 0.125 mg (1/4 pill) per week this month. Is that too fast? How slow should I taper 0.5 mg?

 

Also is Gabapentin OK for insomnia? I've tried that before (300 mg) and it was pretty good for sleep. Or is Gabapentin not good because it works on GABA like benzos do?

 

I think this particular insomnia is due to me shifting my sleep schedule forward ~12 hours all of a sudden,  because I was sleeping fine before that when I was tapering this month.

 

A quarter of a pill is too fast. Most recommend 5 to 10% cut every 7 to 10 days.It all depends on the individual. But you are cutting 25% a week and that is too much.

 

PG